Quantifying the fatal and non-fatal burden of disease associated with child growth failure, 2000–2023: a systematic analysis from the Global Burden of Disease Study 2023
Issued Date
2026-01-01
Resource Type
eISSN
23524642
Scopus ID
2-s2.0-105023912026
Pubmed ID
41344792
Journal Title
Lancet Child and Adolescent Health
Volume
10
Issue
1
Start Page
22
End Page
38
Rights Holder(s)
SCOPUS
Bibliographic Citation
Lancet Child and Adolescent Health Vol.10 No.1 (2026) , 22-38
Suggested Citation
Troeger C.E., Arndt M.B., Aalruz H., Abdoun M., Abdullahi A., Abebe M., Abedi A., Abie A., Aboagye R.G., Abolhassani H., Abtew Y.D., Abu-Zaid A., Adamu L.H., Adane M.M., Addo I.Y., Adegboye O.A., Adekanmbi V., Adetunji J.B., Adnani Q.E.S., Adzigbli L.A., Afzal M.S., Afzal S., Aggarwal N., Ahmad A., Ahmad M.M., Ahmad S., Ahmadi E., Ahmed A., Ahmed H., Ahmed M.S., Ahmed M., Ajami M., Aji B., Al Hasan S.M., Al Omari O., Alam M.K., Albashtawy M., Alemnew F., Al-Eyadhy A., Ali M.U., Ali R., Ali S.S., Ali W., Almazan J.U., Al-Mekhlafi H.M., Alsabri M.A., Alshahrani N.Z., Altaf A., Alvis-Guzman N., Al-Wardat M., Aly H., Amugsi D.A., Anil A., Anteneh Z.A., Anuoluwa B.S., Anvari S., Anyasodor A.E., Arabloo J., Aravkin A.Y., Areda D., Arooj M., Artamonov A.A., Arumugam A., Aryntayeva N., Asiamah-Asare B.K.Y., Athari S.S., Atout M.M.d.W., Aweke A.M., Awotidebe A.W., Ayenew A.A., Azanaw M.M., Aziz S., Babu G.R., Bai R., Baker J.L., Balcha W.F., Banik P.C., Bardhan M., Barrow A., Bashir S., Basiru A., Bassat Q., Bastan M.M., Behera P., Bell M.L., Bemanalizadeh M., Bhadoria A.S., Bhaskar S., Bhattacharjee P., Bhatti J.S., Bisignano C., Biswas B., Bodhare T., Bolla S.R., Boppana S.H., Capodici A., Chandika R.M., Chattu V.K., Chaudhary A.A., Chekole M.S. Quantifying the fatal and non-fatal burden of disease associated with child growth failure, 2000–2023: a systematic analysis from the Global Burden of Disease Study 2023. Lancet Child and Adolescent Health Vol.10 No.1 (2026) , 22-38. 38. doi:10.1016/S2352-4642(25)00303-7 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114667
Title
Quantifying the fatal and non-fatal burden of disease associated with child growth failure, 2000–2023: a systematic analysis from the Global Burden of Disease Study 2023
Author(s)
Troeger C.E.
Arndt M.B.
Aalruz H.
Abdoun M.
Abdullahi A.
Abebe M.
Abedi A.
Abie A.
Aboagye R.G.
Abolhassani H.
Abtew Y.D.
Abu-Zaid A.
Adamu L.H.
Adane M.M.
Addo I.Y.
Adegboye O.A.
Adekanmbi V.
Adetunji J.B.
Adnani Q.E.S.
Adzigbli L.A.
Afzal M.S.
Afzal S.
Aggarwal N.
Ahmad A.
Ahmad M.M.
Ahmad S.
Ahmadi E.
Ahmed A.
Ahmed H.
Ahmed M.S.
Ahmed M.
Ajami M.
Aji B.
Al Hasan S.M.
Al Omari O.
Alam M.K.
Albashtawy M.
Alemnew F.
Al-Eyadhy A.
Ali M.U.
Ali R.
Ali S.S.
Ali W.
Almazan J.U.
Al-Mekhlafi H.M.
Alsabri M.A.
Alshahrani N.Z.
Altaf A.
Alvis-Guzman N.
Al-Wardat M.
Aly H.
Amugsi D.A.
Anil A.
Anteneh Z.A.
Anuoluwa B.S.
Anvari S.
Anyasodor A.E.
Arabloo J.
Aravkin A.Y.
Areda D.
Arooj M.
Artamonov A.A.
Arumugam A.
Aryntayeva N.
Asiamah-Asare B.K.Y.
Athari S.S.
Atout M.M.d.W.
Aweke A.M.
Awotidebe A.W.
Ayenew A.A.
Azanaw M.M.
Aziz S.
Babu G.R.
Bai R.
Baker J.L.
Balcha W.F.
Banik P.C.
Bardhan M.
Barrow A.
Bashir S.
Basiru A.
Bassat Q.
Bastan M.M.
Behera P.
Bell M.L.
Bemanalizadeh M.
Bhadoria A.S.
Bhaskar S.
Bhattacharjee P.
Bhatti J.S.
Bisignano C.
Biswas B.
Bodhare T.
Bolla S.R.
Boppana S.H.
Capodici A.
Chandika R.M.
Chattu V.K.
Chaudhary A.A.
Chekole M.S.
Arndt M.B.
Aalruz H.
Abdoun M.
Abdullahi A.
Abebe M.
Abedi A.
Abie A.
Aboagye R.G.
Abolhassani H.
Abtew Y.D.
Abu-Zaid A.
Adamu L.H.
Adane M.M.
Addo I.Y.
Adegboye O.A.
Adekanmbi V.
Adetunji J.B.
Adnani Q.E.S.
Adzigbli L.A.
Afzal M.S.
Afzal S.
Aggarwal N.
Ahmad A.
Ahmad M.M.
Ahmad S.
Ahmadi E.
Ahmed A.
Ahmed H.
Ahmed M.S.
Ahmed M.
Ajami M.
Aji B.
Al Hasan S.M.
Al Omari O.
Alam M.K.
Albashtawy M.
Alemnew F.
Al-Eyadhy A.
Ali M.U.
Ali R.
Ali S.S.
Ali W.
Almazan J.U.
Al-Mekhlafi H.M.
Alsabri M.A.
Alshahrani N.Z.
Altaf A.
Alvis-Guzman N.
Al-Wardat M.
Aly H.
Amugsi D.A.
Anil A.
Anteneh Z.A.
Anuoluwa B.S.
Anvari S.
Anyasodor A.E.
Arabloo J.
Aravkin A.Y.
Areda D.
Arooj M.
Artamonov A.A.
Arumugam A.
Aryntayeva N.
Asiamah-Asare B.K.Y.
Athari S.S.
Atout M.M.d.W.
Aweke A.M.
Awotidebe A.W.
Ayenew A.A.
Azanaw M.M.
Aziz S.
Babu G.R.
Bai R.
Baker J.L.
Balcha W.F.
Banik P.C.
Bardhan M.
Barrow A.
Bashir S.
Basiru A.
Bassat Q.
Bastan M.M.
Behera P.
Bell M.L.
Bemanalizadeh M.
Bhadoria A.S.
Bhaskar S.
Bhattacharjee P.
Bhatti J.S.
Bisignano C.
Biswas B.
Bodhare T.
Bolla S.R.
Boppana S.H.
Capodici A.
Chandika R.M.
Chattu V.K.
Chaudhary A.A.
Chekole M.S.
Author's Affiliation
University of Washington
Johns Hopkins University
UNSW Sydney
Karolinska Institutet
Chinese University of Hong Kong
King Saud University
Washington University in St. Louis
Cleveland Clinic Foundation
Newcastle University
University of Washington School of Medicine
Korea University
Universiti Malaya
Tehran University of Medical Sciences
Universität Basel
University of Miami Leonard M. Miller School of Medicine
Deakin University
University of KwaZulu-Natal
University of Florida College of Medicine
Shahid Beheshti University of Medical Sciences
Flinders University
Drexel University
University of Tennessee Health Science Center
John Sealy School of Medicine
Manipal Academy of Higher Education
Institució Catalana de Recerca i Estudis Avançats
Qatar University
Isfahan University of Medical Sciences
The University of Jordan
Jordan University of Science and Technology
University of Sharjah
Sultan Qaboos University
The University of Sydney School of Medicine
Jamia Millia Islamia
COMSATS University Islamabad
National Cerebral and Cardiovascular Center
Universitas Padjadjaran
Sant'Anna Scuola Universitaria Superiore Pisa
Jazan University
Charles Sturt University
Bispebjerg Hospital
Imam Mohammad Ibn Saud Islamic University
School of Medicine
Al Farabi Kazakh National University
Jouf University
Lebanese American University
University of Lahore
University of Ilorin
University of South Wales
Nazarbayev University
University of Jeddah
School of Life Sciences
School of Medicine (IUMS)
Université Ferhat Abbas Sétif 1
Bahir Dar University
Instituto de Salud Global de Barcelona
Ministry of Health and Family Welfare
Majmaah University
University of Management and Technology Lahore
Datta Meghe Institute of Higher Education & Research (Deemed to be University)
Alfaisal University
Maharishi Markandeshwar (Deemed to be University), Mullana
Guilan University of Medical Sciences
Bayero University
Menzies School of Health Research
Yale School of the Environment
Shaqra University
The University of Agriculture, Peshawar
Zanjan University of Medical Sciences (ZUMS)
Universidad de Cartagena
Universidad de la Costa
Central University of Punjab
Al-Zaytoonah University of Jordan
All India Institute of Medical Sciences Rishikesh
Al Al-Bayt University
Sana'a University
All India Institute of Medical Sciences, Bhubaneswar
Children's Hospital of Nanjing Medical University
University of Maiduguri
Institute for Biomedical Problems, Russian Academy of Sciences
Universitas Jenderal Soedirman
Arba Minch University
University of Health and Allied Sciences, Ghana
Institute for Health Metrics and Evaluation
Osun State University
Debre Berhan University
Dilla University
Philadelphia University
African Population and Health Research Center
Asfendiyarov Kazakh National Medical University
Research Center for Immunodeficiencies
University of Swat
Federal University Dutse
Rawalpindi Medical University
IUMS Health Management and Economics Research Center
Non-Communicable Diseases Research Center
University of Medical Sciences
Abasyn University
Federal University, Wukari
University of The Gambia
Semey Medical University
Institute of Endemic Diseases Sudan
Bangladesh University of Health Sciences
Institute of Public Health
King Edward Memorial Hospital
Equator University of Science and Technology
NSW Brain Clot Bank
Ottawa University
Romagna Local Health Authority
Johns Hopkins University
UNSW Sydney
Karolinska Institutet
Chinese University of Hong Kong
King Saud University
Washington University in St. Louis
Cleveland Clinic Foundation
Newcastle University
University of Washington School of Medicine
Korea University
Universiti Malaya
Tehran University of Medical Sciences
Universität Basel
University of Miami Leonard M. Miller School of Medicine
Deakin University
University of KwaZulu-Natal
University of Florida College of Medicine
Shahid Beheshti University of Medical Sciences
Flinders University
Drexel University
University of Tennessee Health Science Center
John Sealy School of Medicine
Manipal Academy of Higher Education
Institució Catalana de Recerca i Estudis Avançats
Qatar University
Isfahan University of Medical Sciences
The University of Jordan
Jordan University of Science and Technology
University of Sharjah
Sultan Qaboos University
The University of Sydney School of Medicine
Jamia Millia Islamia
COMSATS University Islamabad
National Cerebral and Cardiovascular Center
Universitas Padjadjaran
Sant'Anna Scuola Universitaria Superiore Pisa
Jazan University
Charles Sturt University
Bispebjerg Hospital
Imam Mohammad Ibn Saud Islamic University
School of Medicine
Al Farabi Kazakh National University
Jouf University
Lebanese American University
University of Lahore
University of Ilorin
University of South Wales
Nazarbayev University
University of Jeddah
School of Life Sciences
School of Medicine (IUMS)
Université Ferhat Abbas Sétif 1
Bahir Dar University
Instituto de Salud Global de Barcelona
Ministry of Health and Family Welfare
Majmaah University
University of Management and Technology Lahore
Datta Meghe Institute of Higher Education & Research (Deemed to be University)
Alfaisal University
Maharishi Markandeshwar (Deemed to be University), Mullana
Guilan University of Medical Sciences
Bayero University
Menzies School of Health Research
Yale School of the Environment
Shaqra University
The University of Agriculture, Peshawar
Zanjan University of Medical Sciences (ZUMS)
Universidad de Cartagena
Universidad de la Costa
Central University of Punjab
Al-Zaytoonah University of Jordan
All India Institute of Medical Sciences Rishikesh
Al Al-Bayt University
Sana'a University
All India Institute of Medical Sciences, Bhubaneswar
Children's Hospital of Nanjing Medical University
University of Maiduguri
Institute for Biomedical Problems, Russian Academy of Sciences
Universitas Jenderal Soedirman
Arba Minch University
University of Health and Allied Sciences, Ghana
Institute for Health Metrics and Evaluation
Osun State University
Debre Berhan University
Dilla University
Philadelphia University
African Population and Health Research Center
Asfendiyarov Kazakh National Medical University
Research Center for Immunodeficiencies
University of Swat
Federal University Dutse
Rawalpindi Medical University
IUMS Health Management and Economics Research Center
Non-Communicable Diseases Research Center
University of Medical Sciences
Abasyn University
Federal University, Wukari
University of The Gambia
Semey Medical University
Institute of Endemic Diseases Sudan
Bangladesh University of Health Sciences
Institute of Public Health
King Edward Memorial Hospital
Equator University of Science and Technology
NSW Brain Clot Bank
Ottawa University
Romagna Local Health Authority
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Child growth failure (CGF), which includes underweight, wasting, and stunting, is among the factors most strongly associated with mortality and morbidity in children younger than 5 years worldwide. Poor height and bodyweight gain arise from a variety of biological and sociodemographic factors and are associated with increased vulnerability to infectious diseases. We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 to estimate CGF prevalence, the risk of infectious diseases associated with CGF, and the disease mortality, morbidity, and overall burden associated with CGF. Methods: In this analysis we estimated the all-cause and cause-specific (diarrhoea, lower respiratory tract infections, malaria, and measles) disability-adjusted life-years (DALYs) lost and mortality associated with stunting, wasting, underweight, and CGF in aggregate. We combined the burden associated with mild, moderate, and severe forms of CGF: stunting was defined as height-for-age Z scores (HAZ) less than –1, underweight was defined as weight-for-age Z scores (WAZ) less than –1, and wasting was defined as weight-for-height Z scores (WHZ) less than –1, according to WHO Child Growth Standards. Population-level continuous distributions of HAZ, WAZ, and WHZ were estimated for 2000 to 2023 using data from surveys, literature, and individual-level study data. The risk of incidence of, and mortality due to, diarrhoea, lower respiratory infections, malaria, and measles was separately estimated in a meta-regression framework from longitudinal cohort data for Z scores less than –1. Finally, fatal outcomes associated with these diseases were estimated with vital registration, verbal autopsy, and case-fatality data, while non-fatal outcomes were estimated with surveys as well as health-care utilisation and case reporting data. The exposure prevalence and relative risk estimates were from continuous distributions, allowing for direct assessment of the attributable fractions for mild, moderate, and severe stunting, underweight, wasting, and the combined impact of child growth failure within populations. All estimates were age-specific, sex-specific, geography-specific, and year-specific. Findings: We estimated that, in children younger than 5 years in 2023, CGF was associated with 79·4 million (95% uncertainty interval [UI] 47·0–106) DALYs lost and 880 000 (517 000–1 170 000) deaths. This represented 17·9% (10·6–23·8) of 444 million (434–457) total under-5 DALYs and 18·8% (11·1–25·0) of all 4·67 million (4·59–4·75) under-5 deaths. Compared to stunting (33·0 million [24·1–42·2] DALYs, 373 000 [272 000–477 000] deaths) and wasting (39·2 million [23·8–53·0] DALYs, 428 000 [256 000–583 000] deaths), childhood underweight was associated with the largest share of CGF-related disease burden: 52·2 million (21·9–75·1) DALYs and 573 000 (236 000–824 000) deaths in children younger than 5 years in 2023. Interpretation: CGF remains a leading factor associated with death and disability in children younger than 5 years, despite global attention and focused interventions to reduce the prevalence of associated CGF indicators. Our findings underscore the need for policies, strategies, and interventions that focus on all indicators of CGF to reduce its associated health burden. Funding: Gates Foundation.